Abstract:

Objective Surgical treatment of recurrent primary spontaneous pneumothorax involves resection of apical bulla and pleurodesis. Postoperative recurrence rates between 5 and 10% are reported. In this study, we aimed to compare the effectiveness and recurrence rates of two different mechanical pleural abrasion methods that we applied in our clinic. Materials and Methods Between January 2012 and December 2019, 112 patients underwent videothoracoscopic bullectomy and parietal pleural abrasion as a surgical treatment for primary spontaneous pneumothorax. Patients' age, gender, smoking history, reason for surgery, presence of bulla in surgery, pleurodesis method, chest tube drainage time, length of hospital stay, postoperative complications, postoperative recurrence and follow-up were retrospectively analyzed. Results The indication for surgery was recurrent pneumothorax in 91 (81.2%) of the patients, while prolonged air leakage continued for more than 7 days in 21 (18.7%) patients. For mechanical pleurodesis to the parietal pleura, 38 (33.9%) patients were abrasion with gauze, while 74 (66.1%) patients were performed with sterile sandpaper. In the group where we used sterile sandpaper for parietal pleural abrasion, the chest tube drainage time was statistically significantly higher than the group in which we used gauze. However, the recurrence and follow-up time was statistically significantly lower in the group in which we used sterile sandpaper. There was no statistically significant relationship between the two groups in terms of other parameters. Discussion In conclusion, videothoracoscopic bullectomy and pleural abrasion is a safe method with low recurrence in the treatment of recurrent primary spontaneous pneumothorax or prolonged air leakage. In addition, the use of sterile sandpaper for parietal pleural abrasion increases the chest tube drainage time slightly but has less recurrence rate.

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